| National Provider Identifier [NPI]: | 1457537136 |
| Last Name Of The Provider | KIEVAL |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 NW 17TH ST |
| Street Address 2 Of The Provider | BASCOM PALMER EYE INSTITUTE, C/O ETI SALAZAR |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331361119 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1555 |
| Number Of Medicare Beneficiaries | 797 |
| Total Submitted Charge Amount | 817591 |
| Total Medicare Allowed Amount | 304454.73 |
| Total Medicare Payment Amount | 224451.86 |
| Total Medicare Standardized Payment Amount | 208110.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1555 |
| Number Of Medicare Beneficiaries With Medical Services | 797 |
| Total Medical Submitted Charge Amount | 817591 |
| Total Medical Medicare Allowed Amount | 304454.73 |
| Total Medical Medicare Payment Amount | 224451.86 |
| Total Medical Medicare Standardized Payment Amount | 208110.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 372 |
| Number Of Beneficiaries Age 75 to 84 | 279 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 495 |
| Number Of Male Beneficiaries | 302 |
| Number Of Non Hispanic White Beneficiaries | 747 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 745 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.92 |